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<br />CITY OF ZEPBYRHILLS PERM7T APPLICATION <br />BUILDING DEPARTMENT 5335 aft St, Zephyrhil1s, FL 33542 <br />813-180-0020 FAX: 813-180-0021 <br /> <br />PHONE CON'lAC'f <br /> <br />/ <br />DAft RJ:CJ:IVJ:D t/?L <br />FOR PERMIftING ~/ JJ 9 d.tf-!:>... <br /> <br />'. - <br /> <br />OWNER'S NAME <br /> <br /> <br />(~J3)9OJK-5()tf / <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT (S) /5"I/'t:, BLOCK SUBDIVISION <br />PARCEL ID . //-d~-:;'I-0J21 tJ- ,;)/3 ()O -I) /. ift:) (OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: j1f-NEW CONSTRUCTION <br />OSIGN <br /> <br />PROPOSED USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAHILY <br />o INDUSTRIAL <br /> <br />0. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HO. <br />o OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIP~ION OF ltORK N'~w ~;i'l.~~' ,L'b~~/" r~8/~I.7C-P <br />BUILDING SIZE SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />~SIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~cc. <br /> <br />PBRMl:TS REQUBSTBD <br /> <br />o BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ C.a t?~c? <br />/5.? <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE ,J!f" Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ ;;J ~ tJ fl,~ VALUATION OF HECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK ~ FRAME <br />FINISHED FLOOR ELEVATIONS 5i1A'~POol <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />kNO <br /> <br />~~__ _____ __ _____ _u __.-___ ______~-~-...-~;:: ~~~>.1~~~~~.:~;?~~~~~~~~ . ~~ <br /> <br />ELECTRIC <br /> <br /> <br /> <br />COMPlIHyA!Hi? 4?..s.li-l' ~~ ~ <br />STATE CaRT OR REGIST I C'.sc..t#X:!~9 y- ~ <br /> <br />BUILDER <br /> <br />****************************************************************** ~ <br /> <br />--- -~ <br />/ COMPANY f-<.tJfJT C(It4..7-? E/~c:6c.C <br />STATE CERT OR REGIST . EC-oa02.:::r-Fi) <br /> <br />************************************************** <br /> <br />PLUMBER <br /> <br /> <br />COMPANY C ol 'ovt ~~ <br />, <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t t....J=.C li:J.~ ?I J <br /> <br />*****'******'******~~;~~"~~~/~ ~ <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . CA.l",:;.?c. 7& <br />:I:-G Pr <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br />